Modeling the impact of COVID-19 on Retina Clinic Performance
Abstract Background COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Ophthalmology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12886-021-01955-x |
| _version_ | 1818859671338876928 |
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| author | Karan Sethi Emily S. Levine Shiyoung Roh Jeffrey L. Marx David J. Ramsey |
| author_facet | Karan Sethi Emily S. Levine Shiyoung Roh Jeffrey L. Marx David J. Ramsey |
| author_sort | Karan Sethi |
| collection | DOAJ |
| description | Abstract Background COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods Clinic event timestamps and demographics were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. Results Retina clinic volume declined by 62 % during the COVID-19 health emergency. Average check-in-to-technician time declined 79 %, total visit length declined by 46 %, and time in the provider phase of care declined 53 %. Patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients-per-provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. Conclusions Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era. |
| first_indexed | 2024-12-19T09:15:53Z |
| format | Article |
| id | doaj.art-3aaffbc0c22f4d7bb852cb2cccbf6aa0 |
| institution | Directory Open Access Journal |
| issn | 1471-2415 |
| language | English |
| last_indexed | 2024-12-19T09:15:53Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Ophthalmology |
| spelling | doaj.art-3aaffbc0c22f4d7bb852cb2cccbf6aa02022-12-21T20:28:06ZengBMCBMC Ophthalmology1471-24152021-05-0121111110.1186/s12886-021-01955-xModeling the impact of COVID-19 on Retina Clinic PerformanceKaran Sethi0Emily S. Levine1Shiyoung Roh2Jeffrey L. Marx3David J. Ramsey4Tufts University School of MedicineTufts University School of MedicineTufts University School of MedicineTufts University School of MedicineTufts University School of MedicineAbstract Background COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods Clinic event timestamps and demographics were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. Results Retina clinic volume declined by 62 % during the COVID-19 health emergency. Average check-in-to-technician time declined 79 %, total visit length declined by 46 %, and time in the provider phase of care declined 53 %. Patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients-per-provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. Conclusions Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.https://doi.org/10.1186/s12886-021-01955-xCOVID-19Health Services ResearchDiscrete‐event simulationPatient flowOutpatient |
| spellingShingle | Karan Sethi Emily S. Levine Shiyoung Roh Jeffrey L. Marx David J. Ramsey Modeling the impact of COVID-19 on Retina Clinic Performance BMC Ophthalmology COVID-19 Health Services Research Discrete‐event simulation Patient flow Outpatient |
| title | Modeling the impact of COVID-19 on Retina Clinic Performance |
| title_full | Modeling the impact of COVID-19 on Retina Clinic Performance |
| title_fullStr | Modeling the impact of COVID-19 on Retina Clinic Performance |
| title_full_unstemmed | Modeling the impact of COVID-19 on Retina Clinic Performance |
| title_short | Modeling the impact of COVID-19 on Retina Clinic Performance |
| title_sort | modeling the impact of covid 19 on retina clinic performance |
| topic | COVID-19 Health Services Research Discrete‐event simulation Patient flow Outpatient |
| url | https://doi.org/10.1186/s12886-021-01955-x |
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